Résumé
Consequences of fasting in Ramadan on the metabolic control of previously poorly. Controlled diabetics are obvious but little described. We followed 20% type 2 diabetic patients with no known complications. They were receiving oral antidiuretic treatment and were poorly controlled with a HhAlc of 9, 6 +/- 2, 1%. They insisted on fasting even when advised not to do it. Clinical parameters, glycaemic and lipoproteins levels were evaluated three times: 20-30 days before Ramadan, between 20 - 27 day in Ramadan and 20 days after the end of Ramadan. Fasting did not change their- weight nor there. Blood pressure. But it worsened the glycaemic control fasting glycemia increased by 2, l mmol/l [p < 0, 01] and fructosamine by 93 rmol/l [p < 0, 03]. However glycated hemoglobin remained unchanged. A 39% reduction in the HDL-cholesterol [p<0,003] was associated with a 24% increase in LDL cholesterol [p < 0, 02]. These parameters returned to their initial levels 20 days after the end of Ramadan. Ramadan, fasting may significantly worsen glycemic and lipoprotein control in initially poorly controlled type 2 diabetic patients
Résumé
We assessed the effects of Ramadan fasting on metabolic control, particularly change of HDL-cholesterol in 25 type 2 diabetic patients treated with diet or oral agents, with good metabolic control. Clinical and biochemical parameters and food intake were evaluated 3 weeks before Ramadan, in the fourth week of Ramadan and 3 weeks after Ramadan.There were no changes in body weight and blood pressure nor any metabolic complications. The mean plasma fasting glucose, serum fructosamin and haemoglobin A1c did not change. We found a negative relation between cholesterol intake during Ramadan and the change of HDL-cholesterol. When cholesterol intake was lower than 400 mg/day, plasma HDL-cholesterol increased by 13% at the end of Ramadan and by 23% 3 weeks after Ramadan